Comorbidity phenotypes and risk of mortality in patients with osteoarthritis in the UK: a latent class analysis

Zemedikun, Dawit T; Lee, Helena; Nirantharakumar, Krishnarajah; Raza, Karim; Chandan, Joht Singh; Lord, Janet M.; Jackson, Thomas

doi:10.1186/s13075-022-02909-4

Cited by 7 publications

(7 citation statements)

References 60 publications

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“…First, illustrating the differences between PTOA and OA has important clinical implications. OA is associated with multimorbidity and polypharmacy [ 40 ]; however, differences exist between comorbidities in PTOA and primary OA. Comorbidity prevention programs in OA should first consider which type of OA the patient has and test for the most prevalent comorbidities for each group.…”

Section: Discussionmentioning

confidence: 99%

Post-traumatic osteoarthritis: the worst associated injuries and differences in patients' profile when compared with primary osteoarthritis

Maia

Annichino

Munhoz

et al. 2023

BMC Musculoskelet Disord

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Background The estimated prevalence of post-traumatic osteoarthritis (PTOA) is 10–12% and in this study 12.4%. Different knee and hip injuries have been identified as risk factors for PTOA, but there is no consensus regarding the most painful and disabling injuries. Identifying these injuries might help in the prevention of PTOA. Additionally, patients with PTOA have a higher risk for complications after arthroplasty than patients with primary OA, perhaps due to differences in the profile and comorbidity that might help to explain the difference. This work aims 1) to identify the most common past injuries associated with the most painful and disabling PTOA cases in non-athlete patients and 2) to compare the comorbidities and characteristics between PTOA and primary OA. Methods Retrospective hospital-based cohort study with 1290 participants with joint complaints or who received arthroplasty. Medical records included demographic information, diagnosis, medication, smoking, alcohol history and comorbidities. Data from January 2012 orthopaedic consults till December 2019 was reviewed and had the type and date of injury, pain score by the numerical rating scale and walking disability. Odds Ratio (OR) and 95% confidence intervals are presented. Results There were 641 cases with primary OA (65% females) and 104 with PTOA (61% males). Patients with PTOA were 7.5 years younger (P < 0.001), reported more alcohol consumption (P = 0.01) and had higher odds of osteoporotic fractures (OP) and psychosis than patients with primary OA (OR = 2.0, CI = 1.06–3.78 and OR = 2.90, CI = -0.91–9.18, respectively). Knee fractures were most common in males and hip fractures in females (31% and 37.5%, respectively, P < 0.005). The PTOA-associated injuries with the highest pain and disability scores were meniscal injuries and hip fractures. Besides, in the group with primary OA, there were more diabetes, hypertension and hypothyroidism cases than in PTOA. However, after adjustment, differences were only significant for diabetes (ORadj = 1.78, CI = 1.0–3.2). Conclusions Past meniscal injuries and hip fractures were the most relevant PTOA-associated injuries regarding pain and walking disability. This, together with differences in their profile when compared with primary OA, might help to decide the orthopaedic management of these injuries to prevent complications such as PTOA and recurrence, with appropriate preoperative planning, surgery choice and comorbidity treatment.

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Section: Discussionmentioning

confidence: 99%

Post-traumatic osteoarthritis: the worst associated injuries and differences in patients' profile when compared with primary osteoarthritis

Maia

Annichino

Munhoz

et al. 2023

BMC Musculoskelet Disord

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“…Найпоширеніші супутні захворювання, пов'язані з ОА -інсульт, виразкова хвороба та метаболічний синдром [72,73]. Пацієнти з тазостегновим/колінним суглобом мали гірші результати смертності порівняно з пацієнтами з ОА рук.…”

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“…Жодних побічних ефектів НПЗП виявлено не було, що свідчить про те, що НПЗЗ можуть забезпечити безпечний варіант фармакологічного лікування ОА. Це заспокоює, враховуючи їх потенційну токсичність для шлунково-кишкового тракту та серцево-судинної системи [72,74,75,76]. Кластер із високим навантаженням із вищою поширеністю хвороб кровообігу/метаболізму/гіпертонічної хвороби та найвищою поширеністю захворювань нирок мав удвічі більший ризик смертності при ОА кисті порівняно зі смертністю, що спостерігається при ОА кульшового/колінного суглобів.…”

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“…Кластер із високим навантаженням із вищою поширеністю хвороб кровообігу/метаболізму/гіпертонічної хвороби та найвищою поширеністю захворювань нирок мав удвічі більший ризик смертності при ОА кисті порівняно зі смертністю, що спостерігається при ОА кульшового/колінного суглобів. Лікування цих супутніх захворювань у клінічній практиці часто переплітається: діабет викликає нефропатію, обидва з яких є факторами ризику серцевосудинних захворювань [72,77]; гіпертонія частіше зустрічається у діабетиків і підвищує ризик серцево-судинних захворювань [72,78]; взаємодія між захворюваннями нирок і серцевосудинною системою є складною та взаємозалежною [72,79].Існує висока поширеність метаболічних захворювань і гіпертензії в кількох кластерах і вища поширеність цих захворювань при ОА тазостегнового та колінного суглобів порівняно з ОА рук. Виживаність вища при ОА кисті порівняно з ОА тазостегнового та колінного суглобів у всіх кластерах мультиморбідності, за винятком кластера з високим тягарем захворюваності.…”

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“…Виживаність вища при ОА кисті порівняно з ОА тазостегнового та колінного суглобів у всіх кластерах мультиморбідності, за винятком кластера з високим тягарем захворюваності. Підвищений ризик смертності спостерігався для слабких і сильних опіоїдів у всіх ОА та контрольних популяціях, хоча шкідливого впливу НПЗЗ не спостерігалося [72]. ОА колінного та та-зостегнового суглобів пов'язана з підвищеним ризиком серцево-судинних захворювань [80,81,82,83].…”

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Osteoarthritis of Knee Joints: The Effect of Concomitant Therapy in Comorbid Pathology

Zhdan,

Lebid,

Ishcheykina

et al. 2023

Act. Probl. of the Modern Med.

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Introduction. Osteoarthritis is the most common disease of the musculoskeletal system, characterized by chronic inflammation and involvement of all components of the joint in the pathological process. Osteoarthritis leads to a decrease in the quality of life, disability of the population, and an increase in mortality. According to experts, osteoarthritis affects about 240 million people worldwide, including approximately 10% of men and 18% of women over the age of 60. In another epidemiological study by American scientists, it was found that that symptomatic knee osteoarthritis occurs in approximately 7% of adults over the age of 25. The prevalence of osteoarthritis is higher in women than in men and increases with age (the trend is present until the age of 70). Approximately 9% of men and 30% of women have at least one joint affected, 11 % and 23% have at least two. Osteoarthritis ranks the 1st position in the structure of musculoskeletal pathology, the 2nd in the number of visits to a family doctor, giving the pass only to cardiovascular diseases, and the 3rd commonest cause of disability. The aim of this study is to analyze and emphasize modern findings regarding the pathogenetic links between osteoarthritis and concurrent comorbid conditions to provide a rationale for novel approaches to enhance the treatment of patients with this pathology. Furthermore, the study aims to evaluate the impact of treatment in patients with gonarthrosis who also present comorbid conditions, with a specific focus on the use of chondroprotective agents such as chondroitin sulphate and glucosamine sulphate, as well as prescription crystalline glucosamine sulphate. Additionally, the study assesses the effects of medications like sartans (e.g., vazar/losartan), statins (e.g., rosart), and nonsteroidal anti-inflammatory drugs (e.g., celecoxib, ibuprofen, diclofenac potassium) in this context. Materials and methods. For this study, we conducted a comprehensive scientific search across both printed and electronic publications and scientific databases. Our research focused on analyzing, comparing, and synthesizing information related to the interplay between osteoarthritis and comorbid pathologies. The study was conducted at the Rheumatology Center at M.V. Sklifosovskiy Poltava Regional Clinical Hospital, which is affiliated with the Department of Family Medicine and Therapy at the Poltava State Medical University. We enrolled a total of 100 participants, comprising both outpatients and inpatients. Among the participants, 81% were women, while 19% were men. Their ages ranged from 48 to 73 years, and all of them presented with primary gonarthrosis at the I-II X-ray stage according to the Kellgren and Lawrence classification in combination with comorbid pathologies. Results. During a 3-month follow-up period, patients under the age of 50 years had mild and moderate manifestations of metabolic syndrome and polymorbid conditions including chronic obstructive pulmonary diseases, lesions of the genitourinary system. Most often, one, rarely two comorbid diseases and one or two diseases that had no proven connection with osteoarthritis were detected. At the age of 50-60, such comorbid processes as arterial hypertension, coronary heart disease, heart failure, obesity, type 2 diabetes, diseases of the digestive system, and polymorbid processes as chronic obstructive pulmonary disease, lesions of the genitourinary system, skin, diseases of the upper respiratory tract, depressive states demonstrated an increasing prevalence. Conclusions. This study has demonstrated a significant clinical effect from applying 3-month therapy that we developed. The therapy, including crystalline glucosamine sulphate and celecoxib, yielded 92% positive response in patients of the main group with osteoarthritis and comorbid pathology. It resulted in a significant reduction in pain, improved joint mobility, enhanced ability to perform daily activities, and positive shifts in laboratory indicators. This led to an improvement in the quality of life, manifested by normalized blood pressure, reduced cardiac and joint pain, and diminished reliance on nonsteroidal anti-inflammatory and antihypertensive medications.

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Cross-Sectional and Longitudinal Associations of Comorbidities with Knee Symptoms and Radiographic Abnormalities of Osteoarthritis

Li,

Pan,

Zhu

et al. 2023

Rheumatol Ther

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Comorbidity phenotypes and risk of mortality in patients with osteoarthritis in the UK: a latent class analysis

Cited by 7 publications

References 60 publications

Post-traumatic osteoarthritis: the worst associated injuries and differences in patients' profile when compared with primary osteoarthritis

Post-traumatic osteoarthritis: the worst associated injuries and differences in patients' profile when compared with primary osteoarthritis

Osteoarthritis of Knee Joints: The Effect of Concomitant Therapy in Comorbid Pathology

Cross-Sectional and Longitudinal Associations of Comorbidities with Knee Symptoms and Radiographic Abnormalities of Osteoarthritis

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